"b.l.o.o.d.y right."
"Here, let me." O"Reilly unbuckled the man"s belt, unb.u.t.toned his shirt, then pulled out the faded blue shirt. There was a bruise as big as a soup plate. O"Reilly stood to face the patient. "This may hurt a wee bit, Liam." He put the flat of one hand on top of the bruise and slipped the other hand under the man"s chest. Liam whimpered when O"Reilly squeezed, and he felt a grating sensation. "Sorry about that. You"ve a rib or two bust there."
Liam nodded but did not speak. His forehead glistened in the light from the overhead bulb.
Pain could certainly make a man sweat, and O"Reilly had no difficulty being empathic with anyone with broken ribs. A b.l.o.o.d.y great boot from an opposing forward had caved in three of his own ribs during a rugby game years ago, and he could still remember the grating pain every time he took a deep breath.
He also remembered vividly another game when a player had taken a thumping, gone to the sidelines to rest for a few minutes, come back to play out the rest of the game-and collapsed in the dressing room. He"d had a ruptured spleen.
Were Liam"s broken ribs alone sufficient to account for his rapid, thready pulse? O"Reilly shook his head. He moved one hand beneath Liam"s ribcage on the left side and tried to depress the muscles of the abdominal wall. They were stiff as a board and unyielding. "Am I hurting you, Liam?"
"By Jesus, you are, Doc." Liam"s words had difficulty getting past his clenched teeth.
O"Reilly lifted his hand gently away. "Can you stand up?"
"I can try." He started to swing his legs over the side of the bed.
O"Reilly waited, hoping the man would succeed. If Liam couldn"t make it under his own steam, O"Reilly wasn"t sure he was strong enough to carry the two hundred-pound man downstairs. O"Reilly was sure the man had a ruptured spleen. The giveaway was his pallor and rapid pulse, along with the rigidity of the abdominal muscles caused almost certainly by blood in the peritoneal cavity. And there was no guarantee that the bleeding from the damaged organ would stop. Death from haemorrhagic shock was a real risk.
"Jesus, Doc," Liam said, "I"m weak as a baby." He breathed in short gasps.
"We"ve to get you downstairs." O"Reilly lifted Liam"s right arm and draped it around his own left shoulder. "Come on. I"ll oxter-cog you."
A ruptured spleen had to be treated at once by surgical removal of the damaged organ. That meant Liam must be taken to the nearest hospital, and it was unlikely that an ambulance, with the necessary attendants to carry him out to the vehicle, could get here in under four hours-if at all with the snow on the roads. If O"Reilly was right, Liam could bleed to death in less time.
G.o.d, he weighed a ton, but he was doing his best to help. Together they made it to the top of the stairs when Liam gasped, "Can we . . . rest for . . . a wee . . . minute?"
O"Reilly himself was panting, and each indrawn breath burnt his lungs. He coughed. Maybe there was some truth in what Barry and young doctors like him were saying about tobacco smoking being bad for your health. "Can . . . can you manage a bit more, Liam?"
Obviously too weak to speak, Liam nodded.
O"Reilly steadied them by putting his hand on the banister and slowly descending, one step at a time. An ornamental wooden bench stood in the hall below. O"Reilly debated sitting Liam down on it so they both could rest but decided against it. He might not get the man back on his feet again. "Come on, Liam . . . almost there," he said, as they reached the hall. He was more than supporting the man now. Liam"s legs were limp, and his feet dragged.
In the kitchen Molly looked up from a sink where she was rinsing a pair of boy"s short pants and underpants. "Jesus, Mary, and Joseph."
"It"s all right, Molly. If you could just . . . open the back door, the back door of the car, and then go and get . . . a couple of blankets . . ." O"Reilly heard his chest wheezing.
She hurried to the door, threw it open, and ran outside.
O"Reilly felt the chill and saw snowflakes being blown inside.
"I"ll get the blankets." She dashed past him, leaving behind her a trail of wet footprints on the tiles.
O"Reilly hauled in one last deep breath, pursed his lips, and forced himself to march ahead, through the kitchen, out the door, and through the lying snow and the once more flying flakes that reflected the rays of light coming from the bulb above the back door. Liam"s head lolled against O"Reilly"s shoulder.
Thank Christ Molly had opened the Rover"s back door. It took his last reserves, but O"Reilly managed to stuff Liam into the back of the car. He stood, hands on the roof, ignoring the chill in them, head bent, mouth gaping as he pulled in lungful after lungful. He could only nod when Molly appeared with blankets, but by the time she had tucked them around Liam, O"Reilly was able to speak.
"You stay with Liam for a minute. I"ve to make a phone call."
"The phone"s in the kitchen."
He didn"t reply but headed straight back to the house, picked up the phone, and dialed the Casualty Department of the Royal Victoria Hospital.
"h.e.l.lo. Who"s that? Registrar on duty? Great. Listen, I need an ambulance sent to the Holywood Arches on the outskirts of Belfast. I"ll need six units of O-positive blood and . . . I beg your pardon? Who do I think I am?" He could feel the blood draining from the tip of his nose. He knew he should be polite, but Liam Gillespie could die if he wasn"t treated soon. "Son. I don"t think I"m anybody. I b.l.o.o.d.y well know who I am. I"m Doctor-did you get that, son?-Doctor Fingal Flahertie O"Reilly from Ballybucklebo. I"m at a farm at the a.r.s.e end of nowhere up in the Ballybucklebo Hills, and I have a patient with a ruptured spleen. That"s right. No, I don"t want the ambulance here. I"ve the patient in the back of my car, and I"ll have him at the Arches by the time the ambulance gets there . . . You"re not sure you can arrange that? You"re too junior to order an ambulance on your own authority? Jesus. Who"s your boss tonight? . . . Sir Donald Cromie?" Sometimes, O"Reilly thought, honey catches more flies than vinegar. He lowered his voice from its quarterdeck-at-sea-in-a-gale level and gently said, "Well look, son, you give old Numb Nuts . . . that"s right, Numb Nuts . . . he and I played rugby together years ago . . . give him a call right away, tell him who phoned and why, and I"ll be surprised if the ambulance isn"t waiting for me at the Arches . . . You will do that? Good lad."
O"Reilly hung up and looked round for his overcoat. He"d have a quick word with Molly, tell her what was going on, send her back to her kids. Then he"d drive up to the Holywood Arches and make sure Liam was safely transferred to the ambulance and transfused if necessary.
O"Reilly lifted the coat from the peg and paused as a sudden gust whirled fresh flakes in through the open door. He"d better get a move on. If it started to drift up on the country roads, even the Rover could have difficulty getting through, and he wasn"t sure how long Liam could live if they got stuck. O"Reilly"s jaw muscles tightened. By G.o.d, Liam Gillespie was going to survive for the rest of his natural span if Fingal O"Reilly had anything to do about it.
He hauled his coat on, strode to the door, and headed back to the Rover.
"Go in and get warm, Molly."
He climbed in, started the engine, and waited as Molly dropped a small kiss on Liam"s forehead.
"Go on," O"Reilly said. "He"ll be fine. I have to go." The second Molly shut the back door he put the car in gear, hunched his shoulders when the tyres spun for a moment before gripping the icy mud of the farmyard, and then relaxed as the big car lurched forward.
As the car jolted down the farm lane, occasional snowflakes dancing in the beams of the headlights, he chided himself for taking things so personally. He"d done everything possible for Liam-more by driving him. If the weather conspired to frustrate his efforts and he did lose his patient, it would hardly be his fault. Every doctor should b.l.o.o.d.y well know that.
O"Reilly stopped at the gate and unlatched it. Then he wrenched it open so forcibly that he bent the top bar. Lose Liam? A few weeks before Christmas? He snorted, and his breath clouds made a little smoke screen.
"Hang on," he called to the backseat as he drove through the gate and onto the road. The gate would just have to stay open. Getting Liam to the ambulance was a d.a.m.n sight more important than a few stray beasts-and anyway weren"t they in the byre?
The going was easier on the road. He"d get through all right so he could stop worrying and concentrate on his driving, and if all went according to plan, O"Reilly grinned, he"d be back at Number 1 Main Street in a couple of hours. His tummy rumbled. He hoped Mrs. Kincaid would keep him something decent to eat. Of course she would, unless young Laverty, who should be home by now, had scoffed the lot.
The Cobbler"s Children Are the Worst Shod.
Somebody opened the front door, and Barry felt the draught in the dining room. Boots clumped in the hall and then paused. O"Reilly would be hanging up his overcoat. Barry was curious about what had taken the man out into this gale and wondered what would be considered a decent interval before asking. O"Reilly"s main preoccupation, quite naturally, would be his stomach. The dining room door flew open, and the big man, blowing on his fingers, stamped in. O"Reilly, Barry thought, never so much entered a room as took it with all the enthusiasm of a storming party a.s.saulting a breach in a castle wall. O"Reilly slammed the door behind him.
"Good evening, Fingal," Barry said. He noticed the snowflakes in O"Reilly"s hair. As O"Reilly clumped past to dump his bulk into his usual chair, he grumbled, "There"s b.u.g.g.e.r all good about it. It"s cold as a witch"s t.i.t, and snowing again out there to beat Banagher. I d.a.m.n nearly didn"t make it back from the Holywood Arches." He coughed, a dry hacking sound, pulled a steaming tureen to him, and ladled stew and a lonely suet dumpling onto his plate. "Decent of you to leave me one of Kinky"s dumplings," he remarked, with his mouth already full.
"I thought you might appreciate it. They were very good." It was childish, Barry knew, but he remembered a night not so long ago when he"d been out on a case and had come home famished to discover that O"Reilly had polished off a whole roast duck. Barry had, after all, left the senior man a dumpling.
Barry heard the door open and half turned to see Mrs. Kincaid, carrying a dish. She had a soft look on her face. "I heard that, Doctor Laverty. I am glad you enjoyed them, so." She moved to the head of the table and lifted the lid of the tureen. "There"s only a shmall, little bit of the stew left, but enough to wet these with the gravy." And so saying, she lifted the dish in one beefy hand and put more dumplings into the tureen.
"You, Kinky, are a miracle worker," said O"Reilly, grabbing the tureen and dumping the entire contents onto his plate. He hacked again.
"And you, Doctor O"Reilly, sir . . ."-she glanced at his ample waistline-"need to go a bit easier on the starches but, och, it is a dirty night out and a body needs a good inside lining."
"Indeed, Kinky. Indeed." O"Reilly impaled the last dumpling on his fork and used it to mop up the remainder of the gravy. "Your stew would give a man the inside lining that beats the cold." He stifled another cough.
Barry saw Kinky"s eyes narrow as she bent to peer more closely at O"Reilly"s ordinarily florid face. "Is it a chill you have, Doctor dear?" she asked.
"Me? Not at all . . . a bit of a dumpling went down the wrong way."
She sniffed, as she herself would say, with enough force to suck a small cat up a chimney. "It sounds like a chill to me."
O"Reilly"s laugh ended in another dry hack. "Mrs. Kinky Kincaid, when I come into your kitchen and advise you on the baking of a ham, you can start the doctoring. Is that fair?"
She pursed her lips and shook her head at him, turned, and started to leave, saying, "I expect you two gentlemen would like some coffee and a slice of cherry cake?"
"Kinky," said Barry, "you are a mind reader."
"Well, trot on upstairs the pair of you, and I"ll bring something up to the lounge. There"s a fire lit and it"s cosier." She hesitated at the door. "It"ll be better for that chest of yours, Doctor O"Reilly, so."
"My chest"s fine, Kinky." Barry heard the edge of finality creeping into O"Reilly"s voice and was surprised when Kinky said, "It"s not my place to say, I know, but I"ve heard it remarked that doctors who doctor themselves have amadans for patients." She left before O"Reilly could answer.
Barry, who had no Gaelic, asked, "What"s an "omadawn," Fingal?"
"An idiot," said O"Reilly. "If anybody else called me that, I"d . . ."
Barry shuddered.
"Sure," O"Reilly said, rising, "it"s only her way of showing she"s concerned. And I"m right as rain." He walked past Barry. "Come on up the stairs and I"ll tell you about the case I"m just back from."
Kinky was right. It was cosy in the upstairs lounge. The curtains over the windows were drawn to keep the heat in and the night out. One curtain fluttered each time a strong gust hit the house, and the old window sashes weren"t completely airtight, but the warmth from a coal fire burning in the grate kept the winter chill at bay.
Lady Macbeth, O"Reilly"s white cat, had preempted the s.p.a.ce on the rug directly in front of the grill of the grate. She was what O"Reilly called "inside out." Her pink nose was tucked into her belly, her tail curled over the top of her head, and in this posture she had somehow managed to manoeuver herself so that she lay on her back.
Arthur Guinness, O"Reilly"s black Labrador, lay flopped at the edge of the rug, his big square head on his paws. He looked dolefully from Lady Macbeth to O"Reilly, as if to say, "That thing is in my place."
O"Reilly bent and scratched the big dog"s head. Arthur"s tail flopped from side to side. "I let him come into the house when the weather"s really nasty, but he"s meant to stay in the kitchen. Aren"t you, sir?"
"Arf," said Arthur, giving not the slightest indication he was going to move.
O"Reilly parked himself in one of the big armchairs.
Barry took the other. He leant back and stretched his legs out in front. G.o.d, but it was comfortable. As curious as he was about O"Reilly"s patient, if he wasn"t careful, Barry could easily fall asleep. His head nodded onto his chest, and his eyelids drooped.
He heard the sc.r.a.ping of a match on sandpaper and smelled the sharp aroma of O"Reilly"s pipe tobacco. His half-doze was shattered by O"Reilly"s paroxysm of coughing. Barry sat bolt upright and stared at his older colleague. O"Reilly bent forward in his chair, arms crossed in front of his stomach, eyes so tightly shut that Barry could see tiny trickles of water being squeezed from their corners.
The outburst scared Lady Macbeth, and Barry was distracted by the white blur of her fleeing from the room and almost colliding with Kinky, who was coming in. He saw Kinky"s eyes widen as she shoved her tray onto the sideboard. She pointed at O"Reilly and, eyes fixed on Barry"s, jerked her head in O"Reilly"s direction. He nodded and rose, intending to go to his senior colleague and perhaps examine him.
O"Reilly straightened up, wiped the back of his hand across his eyes, took a deep breath, blew it out, and said, "Boys-a-boys, maybe those English experts are right." He stared at his weakly smoking briar, still grasped in his left hand, "This tobacco isn"t all that good for you. Particularly when a fellah"s been out on a night like this, lugging a great heavy man around and straining his own lungs."
O"Reilly"s remark about tobacco not being good for you was something of an understatement, Barry thought, as he peered into O"Reilly"s face, hoping the big man had not noticed his sudden frown of concern. Seven years ago the British Medical Research Council had come down heavily in favour of the cause-and-effect relationship between cigarette smoking and lung cancer. He"d taken the warning seriously enough to have quit a year ago. But the same scientists didn"t seem unduly concerned about pipe tobacco, so there was probably nothing sinister happening to O"Reilly. Barry"s frown vanished.
His speculation was cut short by O"Reilly coughing loudly once more. He took another deep breath and stared up at Barry and across to Mrs. Kincaid. "Jesus," he said, "by the faces on the pair of you, you"d think you"d both seen Lazarus rising from the dead. Would you sit down, Barry?"
Barry said levelly, "Fingal, you had the next b.l.o.o.d.y thing to an asthmatic seizure a minute ago. We were worried about you."
O"Reilly cleared his throat. "Nothing to worry about. Sit down."
"We were worried-"
"Well, you can stop worrying. Right now. I told you, I must have inflamed the tubes a bit hauling in great lungfuls of cold air when I was half carrying Liam Gillespie to my car. I"m fit as a fiddle. I"ll be over this in no time." O"Reilly"s cheeks were more florid than usual, but his nose tip was alabaster.
Barry realized it was useless to argue. He sat.
"Now," said O"Reilly, dumping his pipe in the ashtray and rubbing his hands together, "is that the coffee and your cherry cake, Kinky?"
"Aye, so."
"Then let"s be at them. Will you pour, Kinky?"
Barry heard Mrs. Kincaid sniff for the second time that night, and to his surprise he heard O"Reilly add an uncharacteristic "Please?"
"I will," she said, starting to pour. "And will I maybe get a kettle warmed to fix a bit of friar"s balsam for you to inhale?"
O"Reilly seemed to consider the offer, then said, "All right, but just bring up the boiling water and the brown bottle."
Barry was surprised to see the big man cave in so readily to Kinky"s suggestion. It would be something to see, O"Reilly sitting at the table with a jug of boiling water and aromatic herbs, towel over his head like a primitive oxygen tent, inhaling the reputedly beneficial fumes.
"Right," said Mrs. Kincaid, bringing her tray with two cups of coffee and a plate with slabs of her cherry cake over to the coffee table. "I"ll go and see to it." She left the room.
Barry lifted his coffee cup.
O"Reilly grabbed a slab of cherry cake, took a large bite, and coughed. "Bejesus," he said. "I"ve a powerful tickle, so I have." He winked. "But it"s not Kinky"s balsam that"ll be the cure of it." He eyed the decanter on the sideboard, and Barry thought of the hot whiskey he"d had himself not so very long ago. You couldn"t make a hot Irish without boiling water.
Arthur had stirred himself and now sat directly in front of O"Reilly, head tilted, black eyes fixed on every move of the hand that held the cherry cake, twin strings of saliva hanging from the corners of his mouth.
"You should never feed a gun dog people food," O"Reilly said quite seriously, as he shoved the last piece of his cake into Arthur"s mouth. "Now," he said, "if my little bit of a hirstle is of no further interest, I suppose you"d like to hear about who I went to see?"
"Yes, I would. I didn"t know we"d patients as far away as the Holy-wood Arches."
"We don"t. I went to see the Gillespies. They farm up in the Hills. When I saw Liam, I was pretty sure he had a ruptured spleen so I arranged for an ambulance-"
"To meet you at the Holywood Arches, and you ran him up there in your car." O"Reilly"s habit of transporting his patients no longer came as a shock to Barry; indeed he himself occasionally ran someone to the hospital if the urgency was great enough. Back in August he"d driven today"s bride, Julie, to the Royal when she"d been miscarrying.
"b.l.o.o.d.y good thing I did too," O"Reilly said. "Liam was flat as a pancake when I got him there, but the ambulance was waiting and we were able to get him aboard and a blood transfusion started. His blood pressure came up after we"d got a couple of pints into him."
"And he"ll have his spleen out tonight?"
"I would imagine-" Whatever he was about to imagine was interrupted by a crash.
Barry jumped at the sudden sound and tried to understand what had happened. Lady Macbeth must have crept back into the room, jumped onto the tray to try to get at the milk jug, and tipped the whole shebang over. The tray had fallen from the coffee table, and the milk jug lay overturned on the carpet. Lady Macbeth, howling like a banshee, tail fluffed like an electrocuted lavatory brush, was halfway up a window curtain and heading north to the pelmet. Arthur Guinness, without a by-your-leave, was finishing the last slice of cherry cake.
"Jesus," said O"Reilly, shooing Arthur away. "It"s like feeding time at Whipsnade b.l.o.o.d.y Zoo." He turned and stared at Lady Macbeth, where she now sat on the pelmet above the curtains, washing her paws. "And you, madam, can stay there. You clawed me the last time I had to get you down."
Barry, bending to recover the tray and its contents and then setting them on the table again, remembered the incident. He was making a mental note that he too was not going to volunteer to rescue O"Reilly"s cat when O"Reilly hacked loudly and said, as if the carnage of a moment ago simply had not happened, "Aye. Liam would have his spleen out tonight, I"m sure, and with a bit of luck he"ll be home and up and doing in time for Christmas." He coughed and spluttered again, hauled a hanky from a trouser pocket, and dabbed his eyes.
"And," said Barry, as gently as he could, "I"d think by the sound of you that all that gallivanting around in a snowstorm in that old Rover car has given you a touch of tracheitis. Do you think we"ll have you up and doing in time for Christmas?"